Orthopedic resident education on postoperative pain control: bridging knowledge gaps to enhance patient safety

Inpatient hospital pain services3'4 can be of tangible benefit for these complex pain patients.5 Miaskowski and colleagues found that patients cared for by an acute pain service were discharged sooner, had lower pain intensity scores, lower incidences of pruritis, sedation and nausea compared to those without the anesthesia service involvement.5 With a growing number of surgical cases, pain management consultations have increased to a number that is not always sustainable, leading some hospitals to adopt a nurse care model.6 There is minimal medical literature assessing the types of pain management consultations.4 A local and unpublished study on resource utilization at Mayo Clinic Rochester demonstrated that orthopedic surgeons place roughly 40% of all surgical specialty consultation requests for acute postoperative pain management. A smaller number of these requests are focused on interventional pain procedures, such as joint injections. Since not all hospitals have dedicated inpatient pain services, this places additional pressure on surgeons in the perioperative period, making pain education for these specialties even more important. [...]if patients routinely had their medications optimized prior to arrival to the hospital floor, one could reasonably expect better pain control and more efficient use of perioperative resources to address other medical concerns. Since dedicated inpatient pain services are not universally available, while large numbers of chronic pain patients continue to grow in number, there is an increasing need for physicians of all specialties to acquire fundamental pain medicine knowledge.